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Case Study

Can Strain/Injury lead to Infertility?
Dr N L Tiwari

Mr MS 33 yrs, has been married since two years. Wife is 28 yrs old
Education: B Com; Diploma in computers, studied LLB 1st Yr.
Occupation: Fruit Merchant.
He consulted me in 2002 for following complaints

  1. No child. Married since 2 yrs.
  2. Past h/o injury to Rt testes resulted in pyocoele; got operated in Feb. 2000, (2 months after marriage). Rt testes was removed.
  3. Obesity. Wt increased to 93 kgs.
  4. Pain both knees, Heel pain since 6 months.
  5. Anxiety & tension in work area.. Financial difficulties. Because of tension twitching & stretching of eyes, head heaviness, Nausea, wears spectacles. Vision 1number 1, now ½ number.(-1; now -0.5)
  6. Constipation: Irregular time of eating; occasionally passes blood in the stool.
  7. Habit of Masturbation from the age of 16 years.

After marriage it has become less but he does not get sexual gratification with wife and has to resort to masturbation. This results in stressed relationship between husband and wife. Fights occurs between Husband and wife due to strained relationship between his parents and in-laws. Wife’s indifference during sexual intercourse results in fight. Both Husband and wife have consulted for infertility. Wife apparently healthy. She has been investigated. Tubes were patent. No major illness.

Husband semen analysis. 5/4/02:
Abstinence more than 4 days.
Fructose test Positive: pH: 7.4.
Total sperm Count: 22 million/ cc (Normal 50 to 150)
Per ejaculation Count: 77.
Initial sperm Motility in %
Active motile: 35%
Sluggish motile: 15%
Non motile: 50%
Head abnormality: 29%

Life space:
The Patient, is the youngest in a Hindu joint family from Northern India. They have joint kitchen. He has four brothers; all married. Mother alive; Father expired at the age of 50 yrs. Two sisters: both married and settled.
Work: Fruit merchant. Stress 
¹Strain of business during season. Lots of running around. Sleeplessness at night around 2’o clock, gets up at 10 in the morning.
Financial Position adequately sound.
Social Life: Has lot of friends with cordial relations.

Family set up:
Joint family no evidence of active conflict. Family passed though stress and strain between 1996 to 98, because of financial loss. During same time, he got proposal for marriage from one of the sister in law’s family to marry her sister; this created lot of stress in the family. Family was against this proposal as they had already fixed up his marriage.

Wife is loving, but short tempered and out spoken. This creates problems in the family. But gets sorted out. In sexual relations some time co-operative; at times indifferent.

Patient’s Nature:
Irritable3, excitable, easily gets angry, short tempered, sometime results into violence, abusive language and fight. At the same time very emotional and sentimental, get disturbed by seeing people in difficulties.
Ambitious by nature: wants to become big man, wants to earn money to make his family happy and for that will do all his effort to overcome any difficulties.

Physical Characteristics:
Ht 6ft. Wt 94 kgs.
Cravings-sweets3, brinjal2, Non1Veg, mutton2, fish2, Salt3.
Thermals: Cold Bath. Fan full. Covering thin even in winter. Hot Patient.

The Totality:
Basic Nature: Irritable excitable get easily angry.
Craving for Salt3, Sweets3, Pungent.
< sun2.
This pointed to Natrum-mur.
Other Remedies which came for differentiation
 Cal-fl and Lyco.

Points in favor of Calc-fl were:
Ambitious, desire for money, status, power.
Sexual desire increase.
Hot patient but ruled out on the basis of basic nature of the patient as mentioned above.

Lycopodium came in for consideration on the basis of hot patient, craving salt and ambitious, but ruled out on the basis of mental qualities as mention above.

Treatment started on 15th April 2002. Tub-bov as intercurrent and Nat-mur as constitutional remedy. Tub-bov 1M weekly doses. Nat-mur 200 weekly doses.

It has been continued on weekly doses for 12 wks and semen report was done on 20th July 2002. As follows:




Fructose test



Sperm count



Motility Acitve {grade III,IV}



Head abnormality



The response shows marginal improvement in sperm count, definite change in active grade III, IV increase 30%, and definite change in sperm head abnormality. The patient has come down from 93 kgs to 90 kgs,
Treatment continued in similar manner.
 Tub-bov 1M and Nat-mur 200 weekly doses.
On 7/10/02.
 Nat-mur 200 3P Weekly interval. This continued till 3/02/03.
On 20th
 Feb 03 his wife conceived. The treatment stopped.
Now wife is 5th
 months pregnant.